YOUR VOICE. LOUDER.National Rural Health Association Who we areThe National Rural Health Association is a national nonprofit and nonpartisan membership organization with more than 21,000 members. NRHA membership consists of a diverse group of individuals and organizations, all of whom share the goal of improving rural health. NRHA strives to improve the health of the 60 million who call rural America home.

To provide leadership on ruralhealth issues through advocacy,

communications, educationand research.

NRHA's Mission

NRHA's 2019 Rural Health

Award WinnersLegislative Award Sen. Doug Jones, D-ALSen. Martin Heinrich, D-NMRep. Jodey Arrington, R-TXRep. Tom Cole, R-OK

Legislative Staff Katie Campbell - Office of Sen. Doug Jones, D-ALDominique Spadavecchia - Office of Rep. Jodey Arrington, R-TX

Agency StaffGary Bojes, USDA Office of Rural Development

What we fight for

Rural populations are per capita older, sicker, and poorer than their urban counterparts. Continued cuts have devastated the financial viability of rural practice, disrupted rural economies, and eroded availability of care. Medical deserts are appearing across rural America leaving many without timely access to care.

Access to care

Rural areas recruit and retain an adequate health care workforce. 77% of rural counties are Primary Care Health Professional Shortage Areas while 9% have no physicians at all. With far fewer physicians per capita, the maldistribution of health care providers between rural and urban areas results in unequal access to care and negatively impacts rural health.

A robust rural workforce

The federal investment in rural health programs is a small portion of federal health care spending, but it is critical to rural Americans. These safety net programs increase access to health care, improve health outcomes, and increase the quality and efficiency of health care delivery in rural America.

A strong rural health safety net

National Rural Health Association ruralhealthweb.org | @NRHA_Advocacy

THE FACE OF RURAL AMERICA

National Rural Health Association ruralhealthweb.org | @NRHA_Advocacy

Rural 101 - The FactsWho are rural Americans?

Older Sicker Poorer

Why are rural Americans at risk?

Rural Hospital Closures

Approximately 10 million people ages 65 and older live in rural America and a quarter

of older Americans live in a small town or other rural

communities.

According to the CDC, rural Americans are more likely to

die of the five leading causes of death, including heart disease,

cancer, stroke, and chronic lower respiratory disease.

19% of rural Americans, including 25% of rural children, are still living in poverty. Rural

economies are still struggling to recover from the Great

Recession.

Distance and

Isolation

Lack of NecessaryProviders

Multiple Payments

CutsIn an emergency, rural

patients must travel twice as far as urban residents to the closest hospital.

As a result, 60% of trauma deaths occur in

rural America, even though only 20% of

Americans live in rural areas.

Rural hospitals have absorbed $180.3 million in cuts under bad debt

alone. Multiple cuts have caused a loss of more

than 10,000 community jobs in one year and a

$769 million loss to GDP. Across the board cuts don't effect hospitals

equally.

There is a severe shortage of providers and of specialty care

across the continuum of rural health services. This lack of access

means a crisis like the opioid epidemic hits rural America harder - the rate

of overdose deaths in rural counties is 45% higher than in metro

counties.

95 rural hospitals have closed since 2010, and

nearly 700 are vulnerable. Rural

hospitals create not just access to care, but jobs

and economic opportunities as well.

Rural hospitals are often one of the largest

employers in a community.

THE GROWING

DIVIDE BETWEEN

URBAN AND RURAL

AMERICAHealth disparities

continue to grow as care vanishes from rural

communities.

Limited resources, geographic

isolation, low population density,

and persistent poverty create

unique barriers to care in rural communities.

In rural communities poverty rates continue to climb, and opportunities for mobility are disappearing. As incomes decline, so does health.

INCOME AND HEALTH In rural areas there

are significantly higher rates of

chronic diseases, and while these diseases may be curable, in rural America they

are often left untreated, leading to

higher mortality rates and lower life

expectancy.

As rates of cancer deaths drop nationally, CDC research shows that rural Americans are still dying from cancers that should be curable. CDC has found higher mortality rates in rural areas than urban areas, and this gap is growing.

DYING OF CURABLE CANCERS

National Rural Health Association ruralhealthweb.org | @NRHA_Advocacy

DISPARITIES WITHIN RURAL COMMUNITIES

Rural minority communities often experience the worst health outcomes.

Diversity is increasing in rural communities

according to the CDC, unfortunately so are health

disparities within rural communities among and

between different ethnicities.

THE HEALTH STATUS OF RURAL ADULTS

Rural counties with higher percentages of African-American women were more than 4 times as likely to have lost services than those with higher percentages of white women, and more than 10 times as likely to have never had services to begin with.

RURAL COUNTIES WITHOUT OBSTETRICS

National Rural Health Association ruralhealthweb.org | @NRHA_Advocacy

INCREASING RURAL DIVERSITY

Disparities begin before rural children are even born. More than

200 rural obstetrics units closed from 2004-2014. The most vulnerable

communities were the most likely to lose obstetrics services and the most

unlikely to find other care.

MATERNITY CARE IS DISAPPEARING

In rural America, hospitals are one of

the largest employers in the community...

... but we need policies to help

them keep their doors open.

Hospitals, schools, churches… It’s the three-legged stool. If one of these falls down, you don’t have a town.

-John Henderson, CEO and PresidentTexas Organization of Rural & Community Hospitals (TORCH)

The average rural hospital: Employs 321 full-time individuals and invests $7.1 million into local

communities through wages, salaries and benefits.

These providers also create access to care that encourages

employers to open businesses in a community. Without rural

providers, rural America will not have a healthy future.

According to the USDA, nearly 25% of rural children are growing up in poverty, compared to only 20% of

urban children.

Even though 20% of Americans live in rural

counties, these areas make up just 3% of job growth

since the Recession.

Source: The Bureau of Labor Statistics/The Daily Yonder

The rural economy is struggling, but health care may just be its lifeline.

REBUILDING RURAL AMERICA

Rural America did not recover from the Great Recession, and

in many communities, jobs continue to disappear.

Across the country, health care generates jobs and growth. The same is true in rural areas struggling to create opportunities.

National Rural Health Association ruralhealthweb.org | @NRHA_Advocacy